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2020, Number 04

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MediSan 2020; 24 (04)

Effectiveness of ketamine and magnesium sulfate in patients with shaking after subarachnoid anesthesia

Torres MA, Ramírez LB, Romero GLI, Puentes TH, Campos MM

Language: Spanish
References: 18
Page: 578-592
PDF size: 1290.44 Kb.


ABSTRACT

Introduction: The shaking is frequent. Besides increasing the pain, it increases the metabolic demand and the oxygen consumption; several drugs are used to eliminate it.
Objective: To determine the effectiveness of ketamine and magnesium sulfate in patients with shaking after subarachnoid anesthesia.
Methods: A quasi-experimental investigation of 394 patients who received spinal anesthesia in an elective way, assisted at Dr. Juan Bruno Zayas Alfonso Teaching General Hospital was carried out in Santiago de Cuba, from September, 2016 to the same period in 2018. They were divided in 2 random groups with 197 members each one: A (ketamine 0.4 mg/kg) and B (magnesium sulfate 50 mg/kg), to whom the medications were given once shaking began.
Results: In both groups the 45-64 years patients prevailed. There was homogeneity between men and women, without statistical significance (p = 0.5378). Most of those affected were in the group of anesthetic risk II (88.1 %). In the 2 groups the degree III of shaking before therapy prevailed, just 3.5 % in group B maintained the same condition at 30 minutes. In the first 10 minutes of giving the magnesium sulfate shaking disappeared in most of the patients (74.5 %). This drug was effective in 83.8 % of those affected and in those that received ketamine it was of 42.1 %, both without side effects.
Conclusions: The incidence of shaking was high. The ketamine and magnesium sulfate were effective when allowing the disappearance of shaking in a short period of time, but the second drug overcame the first one in a considerable magnitude.


REFERENCES

  1. Ramos G, Grünberg G. Evaluación de la incidencia de temblores en la sala de recuperación postanestésica. Anest Analg Reanim. 2016 [citado 03/03/2019]; 29 (1). Disponible en: http://www.scielo.edu.uy/pdf/aar/v29n1/v29n1a02.pdf

  2. Sánchez Aragón C. Temblor postoperatorio en pacientes mayores de 16 años expuestos a cirugías electivas en el HEODRA. [Tesis]. León: Universidad Nacional Autónoma de Nicaragua; 2015.

  3. González Cardona OE, Cordero Escobar I. Tratamiento de los temblores postoperatorios con meperidina. Ensayo clínico. Rev cuba anestesiol reanim. 2003 [citado 03/03/2019]; 2 (3): 19-26. Disponible en: http://revanestesia.sld.cu/index.php/anestRean/article/view/45

  4. Agurto Fu JF. Ketamina a dosis subanestésicas como profilaxis de temblores posoperatorios en anestesia general. [Tesis]. Lima: Hospital María Auxiliadora; 2019.

  5. Gutierrez Artiga ME, Martinez Barrera MA, Herrera Guzman MJ. Evaluación del manejo del síndrome de Shivering mediante la administración intravenosa de clorhidrato de tramadol en goteo continuo en solución cristaloide, durante la anestesia subaracnoidea en pacientes de 35 a 50 años catalogadas, ASA I y II, en cirugías de histerectomías abdominales atendidas en el Hospital San Juan de Dios de Santa Ana durante el mes de agosto del año 2018. [Tesis] El Salvador: Universidad del salvador; 2018 [citado 03/03/2019]. Disponible en: http://ri.ues.edu.sv/id/eprint/19160/1/INFORME-FINAL-DEFINITIVO-EMPASTADO.pdf

  6. Alcántara Trujillo MJ. Eficacia de la Ketamina para la prevención de temblores postoperatorios en pacientes sometidos a anestesia general. [Tesis] Perú: Universidad Nacional de Trujillo; 2017 [citado 03/03/2019]. Disponible en: http://dspace.unitru.edu.pe/bitstream/handle/UNITRU/12895/Alc%C3%A1ntaraTrujillo_M.pdf?sequence=3&isAllowed=y

  7. Uriostegui Santana L, Nava López JA, Mendoza Escoto VM. Alteraciones de la temperatura y su tratamiento en el perioperatorio. Rev Mex Anestesiol. 2017[citado 03/03/2019]; 40 (1): 29-37. Disponible en: http://www.medigraphic.com/pdfs/rma/cma-2017/cma171e.pdf

  8. Miyakawa H, Matsumoto K, Matsumoto S, Mori M, Yoshitake S, Noguchi T, et al. A comparison of three drugs (pethidine, magnesium sulfate and droperidol) in patients with post-anesthesia shivering. Anesth. 2016; 22 (5): 83-5.

  9. Aguado Barrena OM, Mantilla Borda DL, Ramos Arteaga VD, Pérez Martínez G. Asociación de ketamina y sulfato de magnesio en cirugía de escoliosis para disminuir los requerimientos de morfina posoperatoria: casos clínicos. Rev cuba anestesiol reanim. 2015 [citado 20/03/2019]; 14 (3). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1726-67182015000300009

  10. Farías López RA, Superlano Romero RM. Ketamina vs. sulfato de magnesio para la prevención de temblores postoperatorio en pacientes sometidos a anestesia general. Caracas: Universidad Central de Venezuela; 2012.

  11. Aldrete JA, Paladino MA. Farmacología para anestesiólogos. España: Corpus; 2015. p. 538.

  12. Crossley AWA, Mahajan RP. The intensity of postoperative shivering is unrelated to axillary temperature. Anaesthesia. 1994 [citado 20/03/2019]; 49: 205-7. Disponible en: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2044.1994.tb03422.x

  13. Cordero Tapia A, Cordero-Escobar I. Temblores posanestésicos. Rev cuba anestesiol reanim. 2016 [citado 20/03/2019]; 15 (3). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1726-67182016000300008

  14. Nihar A, Mathews J, Shahbaz H, Gaurishankar R. Comparison of prophylactic use of ketamine, tramadol, and dexmedetomidine for prevention of shivering after spinal anesthesia. J Anaesthesiol Clin Pharmacol. 2018 [citado 20/03/2019]; 34 (3): 352–6. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6194821/

  15. Girmay Fitiwi L, Endale Gebreegziabher G, Amare Hailekiros G, Yilkal Tadesse D, Adugna Aregawi K. Efficacy of intravenous tramadol and low-dose ketamine in the prevention of post-spinal anesthesia shivering following cesarean section: a double-blinded, randomized control trial. Int J Womens Health. 2017 [citado 20/03/2019]; 9: 681–8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5628673/

  16. Sadegh Sanie M, Kalani N, Amin Ghobadifar M, Zabetian H, Hosseini M. The preventive role of low-dose intravenous ketamine on postoperative shivering in children: A placebo randomized controlled trial. Anesth Pain Med. 2016 [citado 20/03/2019]; 6 (3): e32172. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013751/

  17. Bermudez Lopez M. Postanaesthetic shivering – from pathophysiology to prevention. Rom J Anaesth Intensive Care. 2018 [citado 20/03/2019]; 25 (1). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5931188/

  18. Gallegos Mazza CS, Jarrín Jaramillo MF. Hipotermia asociada a temblor en pacientes post- quirúrgicos en el área de recuperación del Hospital Pablo Arturo Suarez. [Tesis] Octubre a diciembre 2018. Quito: Pontificia Universidad católica de Ecuador; 2019 [citado 20/03/2019] Disponible en: http://repositorio.puce.edu.ec/bitstream/handle/22000/16778/Tesis_Hipotermia_GallegosJarr%C3%Adn.pdf?sequence=1&isAllowed=Y




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